Authorities said the boy died because the main vein that runs blood back to heart was torn.

Prosecutor Joe Deters said Pierson has been indicted on charges of aggravated murder, murder and felonious assault. If convicted on all charges, Pierson could be sentenced to death.

Prosecutors said Hamilton County Jobs and Family Services turned the boy back over to his mother after he was hospitalized last year. The stipulation was that Pierson would stay away from the boy, prosecutors said.

Madison said her family called Job and Family Services several times to report that Pierson had been around the boy, but that no one from the service came to intervene.

"If they had stepped up and followed their end of the bargain to make sure their stipulation was followed through with, then he would still be alive," Madison said.

The boy's siblings, ages 7, 5 and 4, have been removed from Burton's care, Deters said.

Madison said blames the boy's mother and his biological father for the death.

"Pamela didn't make those babies by herself. They had a mother and a father, and neither one were there for them. And it's sad because when you've got kids you need to protect them," she said.

Pamela Burton said she hoped Pierson gets the death penalty. Prosecutors said she will likely face a child endangerment charge.